The Surprising Link Between Motorcycles And Better African Health Care

Barry and Andrea Coleman were shocked, during a trip to Somalia in the late 1980s, to see new-looking motorcycles and trucks abandoned by the side of the road. The problem? No one knew how to fix them.

Andrea, a former motorcycle racer, and her husband Barry, a motorcycle enthusiast and journalist, realized after several more trips to Africa that if they could teach people the steps to maintain motorcycles, that would allow health care workers and the medicines they carry to reach patients in rural parts of the country.

Millions of people die every year in Africa from preventable diseases and treatable illnesses like diarrhea, malaria and measles. Very often drugs to treat these illnesses are available –just not in the right place, because they haven’t been delivered. “People assume the infrastructure is in place,” says Andrea Coleman. “It isn’t.”

To address that gap, Andrea and Barry Coleman formed Riders for Health, a UK-based nonprofit, in 1996. Today it operates in seven African countries: The Gambia, Kenya, Lesotho, Malawi, Nigeria, Zambia and Zimbabwe, and employs 300 people there. It manages 1,300 vehicles and the health care workers it enables reach 12 million people. In 2006, the Colemans won a Skoll Award for Social Entrepreneurship from the foundation created by former eBay President Jeff Skoll (see story here) and have also received funding from the Bill & Melinda Gates Foundation.

Results are impressive. It’s helped increase the percentage of fully-immunized infants in The Gambia to 73% from 62%. The rate of malaria has decreased 21% in the Binga district of Zimbabwe, compared to a 44% increase in a neighboring district where Riders is not operating. Equally important, it’s working to make systemic change, working with ministries of health, UN agencies and local aid groups to incorporate logistics and transport into health care planning.

Billionaire philanthropist Jeff Skoll praises the work that Riders For Health does. “The neat thing about Riders was we realized their model could be extended,” Skoll told me when I interviewed him in June. The Skoll Foundation guaranteed a $3.5 million loan issued by GT Bank in Nigeria that paid for all of the vehicles needed in The Gambia (population 1.8 million); Riders for Health now leases these vehicles to the Ministry of Health. “Today, everybody in Gambia has access to health care. It’s a good example of a social entrepreneur with a practical problem that was able to scale,” Skoll explained.

Andrea and Barry Coleman (Photo credit: Tom Oldham)

I had the opportunity to meet the Colemans when they were passing through the San Francisco area in July on their way to the MotoGP World Championship race at Laguna Seca, near Monterrey, Calif. We met, appropriately, at a place called Alice’s Restaurant in Woodside – a motorcycle hangout amidst the redwoods. Black and white photographs of people riding classic motorcycles line the walls of the wood-cabin-like restaurant. Barry explained over an egg breakfast how daily maintenance of motorcycles, properly done, can keep these bikes going even in hot, dusty conditions. “We know the cost per kilometer over the life of a vehicle on any day in seven countries,” he said. “The roads are rougher than here and fuel is harder to get.” But still they get the health care workers out to see the pregnant women and the sick children.

Though Riders for Health is a nonprofit, it sounds like a commercial enterprise. “We send the bill to the Ministry of Health at the end of the month. If the Ministry of health doesn’t pay, we don’t operate the vehicles,” Barry explained. That’s only happened once –and it only lasted for an hour. “We run [Riders] as a business. We are careful with the numbers.”

The Gates Foundation is funding a study being done by Stanford University’s Hau Lee, a professor with expertise in supply chain management. Prof. Lee and his research team are looking at 4 districts within a province in Zambia where Riders for Health is operating and 4 districts where it is not present, comparing logistics efficiency and health worker productivity. The study will run at least through next year and will also look at the outcomes of health interventions.

Lee also created a teaching case about Riders For Health for use with Stanford’s MBA students. Why teach business students about work being done by a nonprofit in Africa? “The innovations of Riders (like vehicle standardization, using proper spare parts inventory control, preventive maintenance schedules, a hub and spoke network, etc.) are good learning lessons for effective operations management in general,” Lee said in an email. Another reason: “Supply chain management and distribution logistics in developing economies pose very different challenges from a developed economy, and I want students to be aware of them. When they work for a global company, it may one day expand to new emerging markets.”

Being part of the Skoll Foundation network of social entrepreneurs has been inspiring for the Colemans. Jeff Skoll has put a particular emphasis on using video and film to get the word out about the work that social entrepreneurs do. As a result, there’s a succinct 2-minute video of Andrea Coleman talking about what Riders For Health does here (produced by the non-profit arm of Skoll’s film company, Participant Media) and a longer video narrated by Ewan MacGregor here.

The Colemans still have plenty of work to do, whether it be expanding in the countries where Riders for Health operates or moving into new countries. But their formula so far is making a difference, which is what gets them up every day.